Can retinopathy explain why some people with diabetes have more severe coronavirus symptoms?

People with diabetes have a greater risk of becoming seriously unwell if they catch coronavirus. Dr Bernabeu wants to investigate why this is. He will find out whether retinopathy can predict who has complications from coronavirus. He also hopes to shed light on the biology behind why retinopathy might make people with diabetes more vulnerable. This could help us find new ways of identifying who is most at risk, so they can be given the best possible advice and care, helping to save lives. Background to research There is growing evidence that people living with diabetes can experience more severe coronavirus (Covid-19) symptoms and have a greater risk of death, but we don't yet fully understand why. We urgently need to identify factors that help to spot which people with diabetes are more likely to become seriously ill, so they can be given the right care and right advice to reduce their risk. Some people with diabetes can develop serious complications with their eyes, called retinopathy. In retinopathy the barrier of cells between the blood and the retina, which has the job of preventing certain substances from entering the tissue of the eye, can breakdown. Dr Bernabeu thinks it's possible that people with diabetes who have retinopathy could be more vulnerable if they catch coronavirus because the virus is able to infiltrate the blood-retinal barrier and attack vital organs. Research aims To test this theory, Dr Bernabeu and his team will first investigate if people with diabetes who have retinopathy are more likely to have worse outcomes from coronavirus. They'll use a database of photographs from the diabetes eye screening programme in Scotland and link this to coronavirus hospital admissions to see if people with retinopathy have a greater risk. Using artificial intelligence, they'll develop ways to predict coronavirus outcomes based on a person's type and stage of retinopathy. They'll then explore how and why retinopathy could cause people with diabetes to be more vulnerable. The researchers have access to tissue samples from people with and without diabetes who sadly died from coronavirus. Dr Bernabeu will look for the presence of the virus in eye tissue samples and investigate if retinopathy predicts the virus reaching other vital organs, including the eye, heart and kidney. Potential benefit to people with diabetes This project will shed light on the biological processes underpinning why people with diabetes are at a greater risk of more severe illness with coronavirus. It could provide a simple, non-invasive way of identifying which people with diabetes are most at risk and would benefit from more intensive treatment and care, to help them make a full recovery from coronavirus.